A Moral Code: Ethical Dilemmas in Medicine

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Amy Ho: Hey everyone and welcome back to Anamnesis by MedPage.

Now, I’m Amy Ho: ER doctor, lover of stories, and your humble podcast host.

We are back for another episode of our medical podcast, which we hope isn’t really a podcast about medicine, but a podcast about life, death, dilemma, the challenges, and sometimes the joys of medicine.

Every episode, we feature stories centralized around a theme about the conflict, the complexity, the heartwarming, and the tragic. In other words, it’s the feelings and emotions that keep us in medicine, practicing the art of what we hope the science can help us achieve.

Now, medicine is complicated because a lot of times there aren’t hard and fast rules — we wish there were, but there aren’t. One treatment isn’t always right or wrong for someone. One surgery isn’t always successful or unsuccessful, and one diagnosis isn’t always correct. Decisions aren’t black and white, they’re varying shades of gray.

So we come up with principles to help handle this — codes if you will. But even those get a bit marred by complexity at times.

As you’ll hear in this episode of Anamnesis with the theme of “A Moral Code: Ethical Dilemmas in Medicine,” one of our biggest codes is “do no harm.” But what is harm? Who decides what harm is, what happens if we disagree?

This opens up — like the theme title says — ethical dilemmas.

So we have in this episode not only three physicians, but three physician/authors who have discussed these very sorts of moral codes and ethical dilemmas in their books to share some of the intricacies of these decisions in the life-changing and sometimes life-ending impact of these decisions.

First up, we have Cedric Dark, MD, MPH, emergency medicine physician and associate professor at Baylor College of Medicine, who’s also the author of a new book Under The Gun: An ER Doctor’s Cure for America’s Gun Epidemic.

He shares with us today his story.

Chapter 1: His Death Would Not Be a Good Death (2:31) — One patient case has this doctor rethinking what separates a good death from a bad death. Story by Cedric Dark, MD, MPH, an emergency medicine physician and an associate professor in the Henry J. N. Taub Department of Emergency Medicine at Baylor College of Medicine in Houston. He is the author of the new book, Under The Gun: An ER Doctor’s Cure for America’s Gun Epidemic.

Chapter 2: Should I Offer My Patient the Option to End His Life? (12:32) — A doctor’s internal debate on whether it’s appropriate to provide her patient with legal options. Story by Jessica Zitter, MD, MPH, a critical care and palliative care physician at Highland Hospital in Oakland, California. She is also the founder of Reel Medicine Media, a nonprofit focused on humanizing end of life care, and is currently working on her third film, “The Chaplain of Oakland.” Zitter is the author of the book, Extreme Measures: Finding a Better Path to the End of Life.

Chapter 3: We Don’t Always Know What’s ‘Best’ for Our Patients (21:09) — When doing the right thing for our patient sometimes feels wrong. Story by Anthony Chin-Quee, MD, a board-certified otolaryngologist. He is also an award-winning storyteller with “The Moth,” and has been on the writing staff of Fox’s “The Resident” and a medical advisor for ABC’s “Grey’s Anatomy.” This story comes from Chin-Quee’s memoir I Can’t Save You, which focuses on his coming of age during medical residency and dealing with a lot of mental health issues that he’s dealt with most of his life.

Episode produced by Genevieve Friedman

Hosted by Amy Ho, MD

Sound engineering by Greg Laub

Theme music by Palomar

Want to share your story? Read the Anamnesis Storyteller Tip Sheet and send us an email at [email protected].